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R. Sharony1, E. Porat1 , R. Autschbach2,
M. Struber3, A. Boening4, R. Kracor2,
A. Haverich3, J. Cremer4,G. Uretzky1
(1) Tel-Aviv Medical Center, Israel, (2)
Heart Center, Leipzig, (3) Hannover Medical School,
(4) University Hospital, Kiel, Germany.
Objectives: Off Pump Coronary Artery Bypass (OPCAB) surgery
to posterior and inferior wall causes hemodynamic instability.
This study evaluates the safety and efficacy of right heart support
during OPCAB surgery to posterior and inferior wall.
Methods: In a multi centerstudy, twenty patients (15 men,
mean age 67 years) underwent multivessel OPCAB surgery. Right
heart support was carried out using the enablerTM.
Hemodynamic measurements were recorded with and without right
heart support.
Results: Mean graft number was 2.25. Cannula positioning
was feasible in all cases, without any device-related mortality
or complications.
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Baseline
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Heart displacement without support
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Heart displacement with support
|
|
CI (L/min/M2)
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2.4±0.5
|
1.6±0.6*
|
2.3±0.6*
|
|
Systolic BP (mmHg)
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114±24
|
76±16*
|
97±17*
|
|
Diastolic BP (mmHg)
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66±16
|
46±10*
|
61±10*
|
*p< 0.05 CI = Cardiac Index; BP = Blood Pressure.
Conclusions: Heart displacement caused a significant hemodynamic
deterioration. The right heart support system improved not only
BP but also CI. The enabler is safe and effective in facilitating
OPCAB surgery.
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